Recurrent UTIs in Women: Here’s What You Need to Know

If you’ve had a urinary tract infection (UTI) before, you know they’re annoying! You have to start running to the bathroom more, it hurts to pee, and somehow you have to get antibiotics.

In the video below, Dr. James Farrell discusses everything you need to know about UTIs.

If you don’t like the video or want more information, continue reading.

What is a UTI?

Simply stated, UTIs are an infection of the urinary tract. They’re usually caused by bacteria, therefore, antibiotics typically solve the problem. If your UTI symptoms do not go away with antibiotics, you may actually have something called painful bladder syndrome and it’s worthwhile to see your urologist to clarify this.

UTIs are most common in women because women have a short urethra, which is the tube you pee through. It’s only about 2-3 centimeters in length. Therefore, it’s not hard for bacteria to travel across your urethra and set up shop in your bladder.

Common risk factors for a UTI include:

Having diabetes.

Having kidney stones.

Being postmenopausal.

Some of you will have the great fortune of having multiple UTIs in a year and this can really impact your quality of life.

UTI trends

My question for these patients tends to be, do you notice a pattern of when you get UTIs? Flights, long car rides, and dehydration tend to be very common things that lead to UTIs because they reduce the number of times you’re going to the bathroom.

However, the most common cause is related to sex. Why? We have a lot of bacteria between our legs. Also, there’s bacteria around the anus and it’s just not that hard for the mechanics of sex to push bacteria into the vagina and urethra.

What’s really important for a women is to make sure that you urinate within 5 to 10 minutes after having sex. Why? This washes any bacteria out from where it shouldn’t be!

Unfortunately, there are all sorts of magazines out there that support all sorts of rituals – there’s really no data to support one ritual over another. Really, all you need to do is urinate after sex.

Sex can also cause small tears in the vagina and urethra. This can reduce some of your natural defenses to fight off infection. This may be from certain positions or lubrication. Regardless, if you’re running into this problem, you’ll know it quickly since it’ll burn to urinate right after you have sex.

General prevention strategies for a UTI include:

Staying well hydrated so that you urinate every 2-3 hours.

When you urinate, make sure you wipe from the vagina back to the anus.

Urinate after sex to wash out any unwanted bacteria.

Consider more breathable, cotton underwear.

Something I’ve found anecdotally helpful for my patients, however, there’s no research to really support this.

UTI treatments

Cranberry juice

Now, you might be doing all of these things and STILL be getting UTIs. In scenarios like this, cranberry can come into play!

Cranberry has an active ingredient that reduces the ability of bacteria to stick to your bladder wall. There are mixed studies on how effective cranberry is. However, the studies that showed support used 10-12 ounces a day of ocean spray cranberry juice cocktail.

There are a lot of cranberry pills or supplements on the market, of which I don’t tend to recommend since it’s hard to check on the purity of their ingredients. Also, because it’s an unregulated market, many of these pills and supplements are very expensive!

D-Mannose

If you don’t want to use cranberry, consider using D-Mannose. It works in the same way by reducing the ability for bacteria to stick to your bladder wall. Studies that were successful with D-Mannose showed that using 2 grams in 200 ml (i.e. ~ 8 ounces) of water daily.

Antibiotics

If neither cranberry or D-Mannose end up working, talk with your doctor about using an antibiotic. See if they recommend using a low dose antibiotic daily or taking an antibiotic before “high risk” UTI scenarios (i.e. before sex, a long car ride or flight). Both of these options can reduce your risk for infections as well.

For women who are postmenopausal, the loss of estrogen reduces the strength of some of your vaginal and urethra tissue. However, a vaginal estrogen cream can be really helpful in giving you some of this tissue balk back for better natural defenses against an infection.

These are a handful of options to prevent or get rid of UTIs. Please, see your doctor to learn about what will be the best options for you moving forward!

If you have any questions, please leave them in the comments below. Thanks!